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The Leading Edge: the Lower Incisal Edge Position

Lower Incisal Edge Position IllustrationToday’s dentist must deliver high quality, beautiful dentistry.  In dental continuing education, there are countless opportunities to learn the techniques to prepare the maxillary anterior teeth and deliver a decent result. However, I am utterly convinced that once a dentist learns and applies the techniques taught by The Dawson Academy, clinical results will become exceptional. 

A complete dentist will deliver more than just a pretty smile; a complete dentist provides a stunning smile that is not only comfortable, but also maintainable long-term.

How can I be so convinced, you ask?  It’s simple. To have beautiful maxillary anterior teeth, it is necessary to have beautiful mandibular anterior teeth.  What’s even better — our patients request this!   I am asked almost daily what can be done to improve the way lower teeth look and I bet you are too.

To best serve our patients, we must embrace this fact: mandibular anterior teeth play a critical role in both function and esthetics.  So much in fact, that The Academy teaches us to begin a 3D treatment plan and evaluation of provisional restorations in the mouth by refining and verifying the lower incisal edge position. 

Dr. Dawson defines this as the “leading edge!”  The leading edge contacting the lingual surface of the maxillary anterior teeth is where the magic happens; the leading edge in motion puts the “FUN” in FUNctional esthetics

Here are a few tips to get you going:

  1. Go back to nature:  Redevelop your appreciation of mandibular anterior teeth.  Spend some time outside the mouth reviewing their beauty--before the days of wear and periodontal disease.   Note the triangular line angles that almost form a “v” at the gingival margin. Appreciate the flat facial profile. Look at the incisal thickness and follow the slight concavity of the lingual-incisal edge. 
  1. Practice recreating the leading edge:  Draw it, wax it, reproduce it in your composites!  
  1. Back to the mouth--start globally:  Teeth have to fit properly in the face.  In addition to the rest position and smile line, the “E” position will help guide decisions to keep the display of maxillary and mandibular teeth balanced as well as age appropriate.  I find this view particularly helpful in deciding if you want to regain incisal length by addition of material versus crown lengthening — for both arches. 
  1. Curve of SpeeRemember the Curve of Spee:  Create an ideal mandibular occlusal plane that exhibits a smooth transition to the posterior teeth.  Establish an anterior guidance that is in harmony with the envelope of function. The front teeth should allow for immediate posterior disclusion.
  1. Prep with complete confidence:  Make a commitment to prep with reduction matrices and accept no excuses (not even from yourself). Inadequate reduction = poor contours of lower teeth.  Chicklets — not in your office!

Predictability is at risk when the opportunity to stabilize and idealize mandibular anterior teeth is missed. 

It is difficult, dare say impossible, to obtain stable centric stops that allow for an anterior guidance in harmony with the envelope of function and that allows immediate posterior disclusion.  Following nature and Dr. Dawson’s lead, you must become confident restoring mandibular anterior teeth. To think of it, in order to be a leading edge dentist-- you must conquer the “leading edge” of the mandibular anterior teeth!

Learn more in The Dawson Academy’s core curriculum and practice implementing those skills in the hands-on Treatment Planning and Restoring Anterior Teeth courses.  

Dr. Johnson grew up in a small coal-mining town in Kentucky. She excelled academically and eventually earned her doctorate from the University of Louisville School of Dentistry. Today, she is one of only a few dentists to be appointed as an Academic Advisor for the prestigious Dawson Center for the Advancement of Dentistry where she assists in training other dentists regarding new clinical techniques and advances. Dr. Johnson and her husband, Jason Johnson (an IT professional), have been married five years and have a beautiful daughter.